ICU护士俯卧位通气知信行现状及影响因素分析

目的 探讨ICU护士俯卧位通气知信行现状及影响因素,为开展相关教学培训提供依据。方法 便利选取北京市5所综合医院209名ICU护士作为研究对象,自行设计ICU护士俯卧位通气知信行调查问卷进行调查。结果 共回收有效问卷190份,ICU护士对俯卧位通气知信行总分（148.75±23.64）分,知识维度得分（75.22±15.33）分,态度维度（37.20±4.59）分,行为维度（36.34±6.89）分;是否是带教老师、是否接受过俯卧位通气培训以及是否护理过俯卧位通气患者是俯卧位通气知信行评分的影响因素(均P<0.05)。结论 ICU护士对俯卧位通气的信念和行为较好,但知识层面有待提高。管理者应根据不同ICU护士的特征开展相应的俯卧位通气培训,以提高护士的知信行水平,促进俯卧位通气在ICU的有效应用。     

临床护士肠内营养相关性腹泻知信行现状及影响因素分析

目的 了解临床护士肠内营养相关性腹泻的知信行现状并分析影响因素,为临床开展相关培训及管理提供参考。 方法 采用自制的一般资料问卷、知识考核问卷和汉化版的护士肠内营养相关性腹泻定义、态度和行为问卷,对1 444名临床护士进行调查。 结果 临床护士肠内营养相关性腹泻知信行得分分别为定义（21.97±2.94）分、态度（20.29±5.35）分、行为（33.17±5.11）分、知识（55.16±17.24）分。多元线性回归分析显示,工作年限、职务、职称、肠内营养护理频率、肠内营养专项培训次数是护士肠内营养相关性腹泻知信行的影响因素（均P＜0.05）。 结论 临床护士肠内营养相关性腹泻知信行水平均有提升空间,护理管理人员需结合护士个人特征,通过开展多模式培训提高其肠内营养相关性腹泻的知信行水平。     

肿瘤患者口服化疗药物安全管理知信行现状调查

目的 调查口服化疗肿瘤患者药物安全管理知信行现状,为制定口服化疗药物健康教育方案提供参考。 方法 采用自行编制的口服化疗药物安全管理知信行调查问卷,对182例口服化疗肿瘤患者进行问卷调查。 结果 口服化疗药物肿瘤患者安全管理知识得分为（43.71±8.70）分,态度（51.10±9.37）分,行为（49.00±7.37）分,知识、态度、行为之间呈正相关（均P＜0.01）;多元线性回归分析显示,影响肿瘤患者口服化疗药物安全管理行为的因素为文化程度、服用口服化疗药物的时间、接受安全管理教育次数（P＜0.05,P＜0.01）。 结论 行口服化疗的肿瘤患者安全管理知信行处于较低水平,应加强肿瘤患者的健康宣教,以保证口服化疗药物的安全使用。     

湖北省临床护士肠外营养知信行现状及培训需求调查研究

目的 了解临床护士对住院患者实施肠外营养的知信行现状及培训需求,为临床开展相关培训提供参考。 方法 采用自制的肠外营养知信行调查问卷,利用便利抽样法选取湖北省16个地级市33所不同等级医院的2 701名临床护士进行网络问卷调查。 结果 临床护士肠外营养知识、态度和行为维度得分率分别为53.90%、90.45%、85.87%,知信行总得分率为77.00%。单因素分析结果显示,工作年限和是否参加过培训是临床护士肠外营养知识、态度和行为的影响因素;医院是否有明确的肠外营养管理制度、医院是否会定期开展肠外营养的质量督查是态度和行为的影响因素（均P＜0.05）。16.62%（449/2 701）名护士认为自己所掌握的知识不能满足当前临床工作的需求;80%以上的护士希望得到肠外营养并发症的预防与处理、肠外营养输注通路选择与维护相关主题培训。 结论 临床护士对住院患者实施肠外营养的态度较积极,行为良好,知识较差。护理管理者应建立和优化培训机制,强化临床护士的知识和行为,提高其对应用肠外营养患者的护理水平。     

银屑病患者皮肤保湿护理知信行现状及影响因素分析

目的 调查寻常型银屑病患者皮肤保湿护理认知、态度、行为现状,分析影响因素,为落实患者皮肤护理健康指导提供依据。 方法 采用自行设计的寻常型银屑病患者皮肤保湿护理知信行问卷,对283例银屑病患者进行调查。 结果 寻常型银屑病患者皮肤保湿护理知识维度得分为（10.20±3.22）分,得分率为72.86%;态度维度得分为（24.14±4.14）分,得分率为80.47%;行为维度得分为（17.63±5.36）分,得分率为70.52%。不同年龄、文化程度、病程患者的认知、态度或行为得分比较,差异有统计学意义（均P＜0.05）。 结论 寻常型银屑病患者皮肤保湿护理知信行水平处于中等偏上水平,其认知和行为水平需要提高。医护人员应结合患者年龄、学历、病程对患者皮肤保湿护理知识进行个性化指导,帮助形成正确的皮肤保湿护理行为,以缓解银屑病症状。     

银屑病患者皮肤保湿护理知信行现状及影响因素分析

目的 调查寻常型银屑病患者皮肤保湿护理认知、态度、行为现状,分析影响因素,为落实患者皮肤护理健康指导提供依据。 方法 采用自行设计的寻常型银屑病患者皮肤保湿护理知信行问卷,对283例银屑病患者进行调查。 结果 寻常型银屑病患者皮肤保湿护理知识维度得分为（10.20±3.22）分,得分率为72.86%;态度维度得分为（24.14±4.14）分,得分率为80.47%;行为维度得分为（17.63±5.36）分,得分率为70.52%。不同年龄、文化程度、病程患者的认知、态度或行为得分比较,差异有统计学意义（均P＜0.05）。 结论 寻常型银屑病患者皮肤保湿护理知信行水平处于中等偏上水平,其认知和行为水平需要提高。医护人员应结合患者年龄、学历、病程对患者皮肤保湿护理知识进行个性化指导,帮助形成正确的皮肤保湿护理行为,以缓解银屑病症状。     

护理本科生课程思政知信行现状及影响因素分析

目的 了解护理本科生对护理专业课程思政知信行现状，并探讨其影响因素，为本科护理专业课程思政教学提供参考。 方法 采用自行编制的护理专业课程思政知信行问卷，对294名护理本科生进行调查。 结果 护理本科生对护理专业课程思政知信行总分为（91.10±10.40）分，其中知识、态度、行为得分分别为（23.71±3.17）、（28.81±4.02）和（38.57±5.06）分。多元线性回归分析显示，对护理专业的喜爱程度、参与相关课程思政教学情况及高校组织思政相关活动情况是护理本科生课程思政知信行的影响因素（均P＜0.05）。 结论 护理本科生对护理专业课程思政的知信行处于中等偏上水平，教学过程中应重点关注非自主选择护理专业、对护理专业喜爱程度低的护理本科生，调动护理本科生参与课程思政积极性，加强并优化课程思政建设的力度和形式，从而进一步提高护理本科生对护理专业课程思政的知信行水平。     

ICU护士简易呼吸器临床应用知信行现状及影响因素

目的 了解ICU护士对简易呼吸器临床应用知识、态度和行为现状,并分析其影响因素,为有针对性地对ICU护士开展简易呼吸器培训提供参考.方法 采用自编的ICU护士简易呼吸器临床应用知信行问卷对重庆市二、三级医院的ICU护士699人进行横断面调查.结果 ICU护士对简易呼吸器临床应用的知识、态度、行为得分及知信行总分分别为15.87±2.91、42.34±5.76、30.82±4.52、89.03±9.74.多元线性回归分析显示,临床工作中是否使用过简易呼吸器、医院或科室是否定期组织简易呼吸器操作练习、简易呼吸器是否为年度技能考核项目是ICU护士简易呼吸器临床应用知信行总分的影响因素(P＜o.05,P＜0.01).结论 ICU护士对简易呼吸器相关知识缺乏全面掌握及更新,其态度较积极,但行为有待提高.应完善培训体系,注重理论与实践的结合,强化培训ICU护士简易呼吸器临床应用知识和行为,以提高其简易呼吸器临床应用知信行水平.     

护理人员对住院患者自杀预防知信行的调查研究

目的 对护理人员住院患者自杀预防的知识、态度、行为水平进行现况调查,为开展护理人员 自杀预防学习提供参考.方法 采用自制护理人员对住院患者自杀预防知信行调查问卷,对445名护理人员进行调查.结果 护理人员对住院患者自杀预防的知识、态度、行为得分分别为(42.56±6.96)分、(30.02±4.31)分、(52.45±8.02)分,总分为(125.00±15.15)分.是否使用过心理评估量表、是否使用过自杀风险评估工具、是否参与患者自杀预防培训是护理人员 自杀预防知信行的主要影响因素(均P＜0.01).结论 护理人员对住院患者自杀预防知识态度行为总体呈中等偏上水平,管理者应当重视并针对护士开展自杀预防的培训学习.     

知信行理论模式用于急诊科护士的患者自杀风险培训

目的探讨知信行理论模式用于急诊科护士患者自杀风险培训的效果。方法组建自杀风险教育多学科团队,采用知信行理论模式对143名急诊科护士进行为期3个月的患者自杀风险培训,比较培训前后护士的自杀态度和自杀护理行为。结果培训后,急诊科护士自杀态度总分及3个维度得分显著低于培训前,自杀护理行为得分显著高于培训前(P0.05,P0.01)。结论知信行理论模式用于急诊科护士患者自杀风险培训可有效改善护士对自杀的态度,规范其患者自杀护理行为。     

The role of oxygen therapy in the recovery phase of day surgery

Oxygen therapy in the inpatient setting is standard practice in the postoperative phase. The aim of this study was to evaluate the need for the routine use of oxygen in the transit phase from the operating theatre to recovery, and its continued use in recovery, in patients undergoing day surgery. ASA I–II patients undergoing body surface surgery, using anaesthetic agents with a rapid recovery profile, are not subject to many of the factors that predispose to postoperative hypoxaemia. This study showed that in our unit the majority of patients do not require oxygen therapy in the theatre-recovery transit phase, and that attention to patient positioning, airway patency, and elimination of the second gas effect may be sufficient. Each day surgery unit (DSU) must make decisions on the need for postoperative oxygen therapy based on the unit layout and the condition of the patient.     

Animal Model for Evaluating Bone Repair with and without Adjunctive Hyperbaric Oxygen Therapy (HBO): Comparing Dose Schedules

The effect of hyperbaric oxygen (HBO) on the healing of standardized metaphyseal defects in the cortices of rat femurs was studied. The question was whether a known total amount of HBO given twice a day (BID) would have a different effect than once a day (QD) treatments. A microvascular casting technique was developed whereby vessel ingrowth at the repair site could be monitored using scanning electron microscopy (SEM). Bone repair morphology was evaluated by light microscopy (LM) and various tissue components were quantified by histomorphometry (HM). Animals were sacrificed I, 2, 3, or 5 weeks postoperatively. SEM revealed that endosteal bone ingrowth was totally responsible for the repair of the cortical defects. Moreover, endosteal vessel ingrowth did not differ between controls and either group of HBO treated animals. LM displayed enchondral ossification in controls and BID treated animals and a pronounced osteoclastic activity in the latter group throughout the repair process. By contrast the QD treated group healed by primary ossification. Judged by the HM data, QD treatment appeared to accelerate bone repair and vessel ingrowth compared to controls, while BID treatment seemed to retard these processes.     

不同供氧方式纠正重型颅脑损伤病人低氧血症效果观察

目的探讨重型颅脑损伤低氧血症病人的最佳氧疗方式。方法随机将68例重型颅脑损伤病人分成对照组(35例)和观察组(33例),在常规治疗的同时,对照组采用传统的鼻导管给氧;观察组采用舒氧康静脉高压给氧。结果观察组其动脉血氧饱和度、氧分压明显提高,两组比较,差异有显著性意义(均P<0.05);两组病死率比较,差异有显著性意义(P<0.05),而两组心率、血压、pH、PaCO2比较,差异无显著性意义(均P>0.05)。结论使用舒氧康静脉高压给氧较鼻导管给氧更能快速、有效纠正重型颅脑损伤病人缺氧状态,纠正低氧血症。     

Hyperbaric oxygen therapy for radiation-induced hemorrhagic cystitis

Abstract:   Hyperbaric oxygen (HBO) therapy has recently emerged as a potential primary option for the management of hemorrhagic cystitis. We review our experience treating hemorrhagic cystitis with HBO. Between January 2001 and May 2007, eight patients with radiation-induced hemorrhagic cystitis underwent HBO therapy. There were five men and three women with a mean age of 64.3 years (47–73). Radiation was given for local disease, and the mean dosage delivered was 56.6 Gy (42–70). The mean duration between the onset of hematuria and the beginning of HBO therapy was 8.9 months (3–34). Mean follow-up period was 15.5 months (2–31). Hematuria resolved completely in six of the eight patients, one of whom suffered recurrence of hematuria and was treated with HBO until the hematuria resolved again. The response rate was 75%, compatible with the previous reports, and no side-effects of HBO were noted. HBO treatment should be attempted for radiation-induced hemorrhagic cystitis.     

Iatrogenic systemic air embolism treated with hyperbaric oxygen therapy

Air embolism is a rare and potentially severe complication of surgical and invasive procedures. Emboli large enough to produce symptoms require immediate treatment because of the risk of 'gas lock' in the right side of the heart and subsequent circulatory failure. If air is transmitted to the arterial circulation through a shunt, it may cause cerebral emboli with neurological symptoms. We present two cases with venous air emboli and concurrent cerebral arterial emboli. Both patients were successfully treated with hyperbaric oxygen therapy.     

Hyperbaric oxygen therapy for radiation-induced haemorrhagic cystitis

OBJECTIVE: To assess the efficacy of hyperbaric oxygen (HBO) for treating haemorrhagic cystitis. PATIENTS AND METHODS: From February 1997 to April 2004, seven patients with radiation-induced haemorrhagic cystitis were treated with HBO; they received a mean (range) of 30 (18-57) HBO treatments and the follow-up was 24 (3-53) months. RESULTS: The haematuria resolved completely in all seven patients shortly after treatment; one had an improvement but died from complications relating to cancer shortly after completing treatment, and two had recurrence of gross haematuria. They were re-treated with HBO until the haematuria resolved. CONCLUSIONS: Radiation-induced haemorrhagic cystitis can be treated successfully with HBO primarily or after failure of standard regimens. This method was well tolerated even in patients debilitated by advanced cancer and blood loss. Long-term remission is possible in most patients, and re-treatment effectively manages recurrent bleeding.     

Pyoderma gangrenosum: A case report of bilateral dorsal hand lesions and literature review of management

Pyoderma gangrenosum is a great masquerader in wound diagnosis and management. Frequently misdiagnosed as a necrotizing infection, the elusive nature of its etiology and pathogenesis has thwarted the establishment of a standardized management algorithm, leaving immunosuppressant therapies as the mainstay of treatment. The present report describes a 61-year-old woman presenting with temporally discrete bilateral dorsal hand lesions successfully managed with distinctive multimodality therapies. The initial lesion was managed under the auspices of a necrotizing process using a combination of hyperbaric oxygen therapy and skin grafting with a negative-pressure dressing, both individually demonstrated to be effective for prompt wound stabilization and coverage. A subsequent contralateral hand lesion was similarly managed as a necrotizing infection before a diagnosis of pyoderma gangrenosum was considered. Stabilization and eventual resolution was achieved using intravenous and topical steroids followed by hyperbaric oxygen therapy, again highlighting the benefits of multimodality therapy in the setting of pyoderma gangrenosum.     

Tracheal intubation of morbidly obese patients: a randomized trial comparing performance of Macintosh and Airtraq laryngoscopes

BACKGROUND: The Airtraq laryngoscope is designed to allow visualization of the glottis without alignment of the oral, pharyngeal, and laryngeal axes. We hypothesized that this new airway device would facilitate tracheal intubation of morbidly obese patients. We compared tracheal intubation performance of standard Macintosh laryngoscope with the Airtraq laryngoscope in morbidly obese patients. METHODS: One hundred and six consecutive ASA I-III morbidly obese patients undergoing surgery were randomized to intubation with the Macintosh laryngoscope or the Airtraq laryngoscope. Induction of anaesthesia was standardized. If tracheal intubation failed within 120 s with the Macintosh or Airtraq , laryngoscopes were switched. Success rate, SpO2, duration of tracheal intubation, and quality of airway management were evaluated and compared between the groups. RESULTS: Preoperative characteristics of the patients were similar in both groups. In the Airtraq group, tracheal intubation was successfully carried out in all patients within 120 s. In the Macintosh laryngoscope group, six patients required intubation with the Airtraq laryngoscope. The mean (SD) time taken for tracheal intubation was 24 (16) and 56 (23) s, respectively, with the Airtraq and Macintosh laryngoscopes, (P<0.001). SpO2 was better maintained in the Airtraq group than in the Macintosh laryngoscope group with one and nine patients, respectively, demonstrating drops of SpO2 to 92% or less (P<0.05). CONCLUSIONS: In this study, the Airtraq laryngoscope shortened the duration of tracheal intubation and prevented reductions in arterial oxygen saturation in morbidly obese patients.